I've been trying to understand the ins and outs of my 18 month old daughter's allergy. She has been diagnosed with an allergy to dairy and eggs. She has had exposure to milk and got hives from it. But she has never been exposed to eggs - until today.

Today, at her daycare a new caregiver gave her two oatmeal cookies. Within minutes she vomited twice, they gave her Benedryl and called us. As they were talking to my husband, they saw that she had hives on her belly but they said she was fine. By the time I got there (which was as soon as I got off the phone with my husband), they had changed her and told me that her breathing seemed a bit constricted. By this time, I was in tears. This is the first time we've had this strong a reaction to anything. So I grabbed her and gave her the epi. Then I gave her some Ventolin. When my husband arrived a few minutes later, we took her to the hospital.

They were quite kind at the ER but not overly concerned - her temp was normal, her breathing seemed fine and her oxygen level was 98%. Anyway, they put us in a room and the doctor came and checked her out. By this time, she had nursed herself to sleep. He told us that we needed to wait 4 hours until the effects of the epi wore off so that they could see if there were any residual effects from the exposure. She was up and around with no problem - pretty much her old self by the time we left.

Though the doctor never said it, I think he felt that I gave her the epi too soon. Or overreacted. I really don't know what I should have done. I admit that I did panic, it was the first time that she had such a severe reaction. But from everything I read - vomiting, hives and restricted breathing are all signs of anaphylaxis. He suggested that the next time it happens to treat with Benedryl and if her lips start to turn blue, then to give her the epi. That seems like a long time to wait....

Keep in mind, we've only been told that she has allergies. No one has ever said that she was anaphylactic to anything. But they told us to get an epipen and keep it with us at all times. And they gave me all this reading material on anaphylaxis. When I ask straight out if she is anaphylactic, they tell me you can't tell.... So I just don't know what I should do.

The other problem is that I have had food allergies for as long as I remember. I have never considered that I was anaphylactic but according the reading material, I am. This just makes me more confused. I carry an epipen but I have never used it and have only ever taken an antihistamine when I've encountered an allergen.

So I don't know if I did the right thing or not. And really, I don't know what I am supposed to do when DD has a reaction. I do know that I'll be speaking with the daycare about the incident and making sure that they make sure that any new people know about her allergies. What's the point of sending her with a lunch and snacks every day, if they are going to just give her random things?

to you Tina. I feel, absolutely, that giving your daughter the Epipen was the right thing to do! She had vomiting, hives AND her breathing was constricted. In my mind, there is no doubt that the Epipen was required. Unfortunately, not all doctor's are well informed regarding the signs of anaphylaxis, and the importance of administering the Epipen. Waiting until her lips turn blue is too long to wait! I'm so sorry that the doctor has you doubting your actions. You cannot harm your child by administering the Epipen, and it's always better to be safe!

My husband and I have been witness to several bad reactions with our son. In the early days, prior to diagnosis, and following initial diagnosis, our son had 3 very bad reactions requiring emergency care (ambulance, hospital) where we did NOT administer the Epipen. They were terrible, and very scary reactions that went on for hours, even at the hospital. We went for some time before he had another reaction, but when he did, I now KNEW I needed to administer the Epipen. Within 5 minutes (or so) you wouldn't even know he had been having a bad reaction, but the ambulance still came and we stayed at the hospital for the required 4-5 hours. He has since that time had 2 more reactions requiring the Epipen (despite our vigilance, accidents can occur); however, I know we should not hesitate in administering the Epipen, and I no longer fear the Epipen.

I hope your daughter, and you and your husband are feeling better soon. It's very emotional to go through this. to you and your family.

Tina, you did the right thing! Your ER doctor is wrong. (I would suggest you take a few days to look after yourself and your family and then follow up with the administration.

Please checkout the link at the end of this post and print it out for the hospital. You need to educate the hospital because this is most likely where you will go in the future should any reactions ever occur again.

Quote:

Key recommendations

There are six key recommendations for dealing with anaphylaxis:

1. Epinephrine is the first line medication that should be used for the emergency management of a person having a potentially life-threatening allergic reaction.

2. Antihistamines and asthma medications must not be used as first line treatment for an anaphylactic reaction.

3. All individuals receiving emergency epinephrine must be transported to hospital immediately (ideally by ambulance) for evaluation and observation.

4. Additional epinephrine must be available during transport to hospital. A second dose of epinephrine may be administered within 5 to 15 minutes after the first dose is given IF symptoms have not improved.9,10

5. Individuals with anaphylaxis who are feeling faint or dizzy because of impending shock should lie down, unless they are vomiting or experiencing severe respiratory distress.11

6. No person should be expected to be fully responsible for self-administration of an epinephrine auto-injector.

Tina You 100% did the right thing, absolutely, without a doubt!!! You should be very proud of yourself
( having been there myself ) it is a very traumatic moment and to give the epi and keep your head is a huge deal. I used the epipen 2 weeks ago and paramedics, RN's, Dr'.s all told me I did the right thing using the epi. and not to hesitate to use it again if I felt DS needed it. I really hope more hospitals get on board with proper anaphylaxis training, it sounds like it is NEEDED greatly.

I hope you have given yourself the chance to unwind, I know I need about a week before I feel back to normal. I would ask staff not to feed your daughter anything other than food you provide. I also would have a huge sit down with them and go over symptoms and the importance of using the epipen asap! Symptoms come in all combinations, DS has a different combo with each reaction which made it very difficult at first for me to determine when to use the epi. I was new to allergies and he was a baby and couldn't talk. Be sure staff understand that she might had different symptoms next time but that doesn't make a reaction any less serious.

to you and yours, Tina. My opinion....you did the right thing. Dd and I have had a few scary moments together and many different reactions from the emergency people when we got to them....the one that made the most impression?....how fast the emerg. doctor and nurse moved when they realized she was reacting to the medicine (pulmicort?)that was supposed to be helping her.

One of the really good things that has came out of this forum is getting used to writing again.....and after your talk with the staff please try to follow it up with a letter.....people do respond to things differently if they are written down. If I could change one thing, it would be that I would have started writing (not just reading) here earlier. It's not easy to express through writing, a person does need to practice, but the written word is very powerefull. All the things that an alllergy mom needs to learn....there is so much.....and much like children....allergies and reactions are different too.

2 of the very top allergists -- Dr. Fenton and Dr. Sampson -- would say so. Here's an excerpt from a media discussion I took part in on the new U.S. Food Allergy Guidelines:

Quote:

Anaphylactic Reactions: Anaphylaxis is defined in the guidelines as a serious allergic reaction which is rapid in onset and may cause death. In the media call, Dr. Hugh Sampson, professor of pediatric allergy and immunology at Mount Sinai School of Medicine and the director of the Jaffe Food Allergy Institute, clarified the definition, saying that having just one symptom, such as hives, would be referred to as an allergic reaction.

When more than one body system is involved, such as both hives and wheezing, it is considered anaphylaxis. On rare occasions, an anaphylactic reaction can occur with just one system acting up, such as “cardiovascular collapse”.

Sampson stressed that you can have “different degrees of anaphylaxis.” For instance, an individual with hives, watery eyes and stuffy nose would be classified as having a mild anaphylactic reaction.

On the other hand, an individual who experiences wheezing and a sudden drop in blood pressure would be said to be experiencing a severe anaphylactic reaction.

Fenton said in the conference call that he hopes the guidelines will also help emergency room physicians recognize some of the less obvious symptoms of anaphylaxis, such as vomiting and diarrhea. Discussions held with these physicians indicate most recognize the classic symptoms, but don’t realize the gastrointestinal symptoms can also be a sign of anaphylaxis.

One more thing, a paramedic will always ask you if you want to go to the hospital. They need permission to transport you so don't think that they aren't taking your situation seriously! Being unconcious implies consent.

Treatment: Treatment: The guidelines state that an epinephrine auto-injector is the first line of defence against an anaphylactic reaction. The life-saving medication should be used at the first sign of an anaphylactic reaction and the person should be brought to the emergency room of a hospital for further treatment and monitoring.

“We recommended that individuals [at risk of anaphylaxis] have some sort of auto-injector with epinephrine with them at all times,” says Sampson, adding that other drugs, such as anti-histamines and corticosteroids, are secondary medications.

Thank you all for the informative responses. They really do make me feel better. I know I did the right thing. DD is doing fine now. She seem

We did speak to the daycare and they have now coded the charts of all the children who have allergies so that any worker will see it immediately. They have also implemented procedure to make sure that all new workers are aware - I thought this was already in place but it seems to have slipped through the cracks.

I think I'm going to print one of those posters the Anaphylaxis site and have them put it on their wall....

2 of the very top allergists -- Dr. Fenton and Dr. Sampson -- would say so. Here's an excerpt from a media discussion I took part in on the new U.S. Food Allergy Guidelines:

Quote:

Anaphylactic Reactions: Anaphylaxis is defined in the guidelines as a serious allergic reaction which is rapid in onset and may cause death. In the media call, Dr. Hugh Sampson, professor of pediatric allergy and immunology at Mount Sinai School of Medicine and the director of the Jaffe Food Allergy Institute, clarified the definition, saying that having just one symptom, such as hives, would be referred to as an allergic reaction.

When more than one body system is involved, such as both hives and wheezing, it is considered anaphylaxis. On rare occasions, an anaphylactic reaction can occur with just one system acting up, such as “cardiovascular collapse”.

Sampson stressed that you can have “different degrees of anaphylaxis.” For instance, an individual with hives, watery eyes and stuffy nose would be classified as having a mild anaphylactic reaction.

On the other hand, an individual who experiences wheezing and a sudden drop in blood pressure would be said to be experiencing a severe anaphylactic reaction.

Fenton said in the conference call that he hopes the guidelines will also help emergency room physicians recognize some of the less obvious symptoms of anaphylaxis, such as vomiting and diarrhea. Discussions held with these physicians indicate most recognize the classic symptoms, but don’t realize the gastrointestinal symptoms can also be a sign of anaphylaxis.

Thanks so much for this information, Gwen. It really helps me to understand what to look for and what can be defined as anaphylaxis or allergy. It seems like I have mild anaphylaxis and DD may have more severe reactions.

We did speak to the daycare and they have now coded the charts of all the children who have allergies so that any worker will see it immediately. They have also implemented procedure to make sure that all new workers are aware - I thought this was already in place but it seems to have slipped through the cracks.

Tina, can you say what province you live in? I see your child is in daycare, not school, but I am now interested in this as well. I too, would think that the daycare would have had something in place prior to this. I know nothing about daycares, luckily we lived very near my mother, who was as allergy aware as me....I have wondered about it though......and tend to think about the next guy.....and what the heck....I may as well jump in with both feet. I sure would like to see some of those cracks filled.

We did speak to the daycare and they have now coded the charts of all the children who have allergies so that any worker will see it immediately. They have also implemented procedure to make sure that all new workers are aware - I thought this was already in place but it seems to have slipped through the cracks.

Tina, can you say what province you live in? I see your child is in daycare, not school, but I am now interested in this as well. I too, would think that the daycare would have had something in place prior to this. I know nothing about daycares, luckily we lived very near my mother, who was as allergy aware as me....I have wondered about it though......and tend to think about the next guy.....and what the heck....I may as well jump in with both feet. I sure would like to see some of those cracks filled.

We live in New Brunswick. The daycare did have a policy in place but they didn't follow it. They forgot to inform the new worker that there were allergic children in the room so she did not know that she needed to get the safe snacks for DD from the fridge.

The daycare did have a policy in place but they didn't follow it. They forgot to inform the new worker that there were allergic children in the room so she did not know that she needed to get the safe snacks for DD from the fridge.

OMG! There needs to be a reminder of this when the new worker signs in (or something).
This is why having photos of the children with their allergy info posted in key areas (classroom, breakroom etc is so important)

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